Fatty Acids and Oxidative Stress and Neurotrophins in Gestational Diabetes Mellitus

Abstract

GDM is associated with abnormal fetal growth, both growth restriction and overgrowth (macrosomia). It is known that LCPUFA levels and oxidative stress influence pregnancy outcome and it is essential to examine their levels, both in the mother from early pregnancy and in the placenta. There are very few reports on LCPUFA levels in GDM. These studies are on the western population. To the best of our knowledge there are no studies from India reporting maternal LCPUFA levels longitudinally across pregnancy. Similarly, placental fatty acid levels have also not been examined in GDM. There is a high prevalence of GDM in India along with suboptimal levels of LCPUFA mainly due to a vegetarian diet. Similarly, the levels of oxidative stress markers in the placenta have not been widely explored with respect to GDM pregnancies. Furthermore, findings have been inconsistent. Studies report lower placental neurotrophin levels in pregnancy complications such as preeclampsia or intra-uterine growth restriction. Earlier studies carried out by us have demonstrated lower maternal and placental levels of BDNF in preeclampsia and lower placental BDNF and NGF in preterm pregnancies. Neurotrophins are known to regulate placental angiogenesis and influence the development and maturation of the feto-placental unit and the fetal growth. To the best of our knowledge there is no data on placental neurotrophins in GDM and its implication for fetal growth. There is a need to conduct studies where maternal age, body mass index (BMI), maternal weight gain during pregnancy and mode of delivery are taken into account, while studying mechanisms in GDM subjects. It is known that changes in the placental structure and function are important determinants of fetal growth and body composition and may link maternal in utero perturbations to fetal programming. However, data regarding the levels of fatty acids, oxidative stress markers and neurotrophins is the placenta is scarce.